Search results

The purpose of this paper is to examine the extent to which, in the five integrated community teams for adults with learning disabilities (CTLDs) in an English county-wide service, the use of psychotropic medication for service users was based on the presence of an appropriate mental health condition or epilepsy.

Adult participants were recruited following referral to one of the CTLDs for assessment, treatment and/or support of a possible mental health and/or behavioural need. Data were collected about participant characteristics and psychotropic medication 12 months after recruitment.

While a total of 42 (78 per cent) of the 54 participants were apparently prescribed regular or PRN (as required) psychotropic medication, only 24 (57 per cent) of these individuals had a recorded past or current mental health condition or epilepsy for which such medicine could be appropriate.

There were several limitations: the sample size was small and its representativeness was uncertain; and data collection was compromised by barriers to explicit knowledge exchange within and across the learning disability service.

While recent guidance about the use of psychotropic medication is welcome, minimising inappropriate use requires more comprehensive person-centred interventions (including crisis management plans), underpinned by imaginative, but feasible, data collection methods and integrated formulations. Investment is needed in developments that support multi-disciplinary and inter-agency working to promote “good practice” by CTLDs in responding to referrals for possible mental health and/or behavioural needs.

Complementing recent large studies of primary care (General Practitioner) records, this is the first examination of the use of psychotropic medication by service users in English CTLDs.

While “generic” community teams for adults with learning disabilities (CTs) are well-established in the UK, very little recent evidence is available about any aspect of their work. As part of a larger project about the role, structure and functioning of CTs, the purpose of this paper is to provide data about referrals.

Over three months, the authors obtained data about 270 consecutive new referrals to five CTs in a countywide integrated health (NHS) and care management (local authority) service.

The 270 referrals related to 255 individuals, mainly already service users, with almost a third (30 per cent, n=204) described as people with severe or profound disabilities. Consistent with the reported living arrangements (residential accommodation or with one or more family members (87 per cent, n=270)), referrals were most often made by social care staff, General Practitioners or carers. The referrals related to a wide range of issues including mental health and/or behavioural needs, physical health and skills, and independence. The major group, however, were requests about a person’s entitlement to specialist learning disability services and/or reviews of an existing social care package.

The focus on new referrals and the exclusion of intra-team referrals mean that the data are not representative of a CT’s caseload and cannot be used as a basis for resourcing. Nevertheless, the findings emphasise the heterogeneity of the population, and the long-term and varied nature of their needs, meaning that CTs require access to a range of expertise and, often, an inter-agency approach. The implications for service design are considered.

This is the first empirical study of referrals to specialist integrated (health and care management) community learning disabilities teams in England.

This study was carried out as part of a larger study commissioned by the UK Department of Health to investigate the service pathways for offenders with learning disabilities (LD). The study covered three health regions in the UK and included 477 people with LD referred to services because of antisocial or offending behaviour during a 12‐month period. Data were collected concerning demographic, individual, offending behaviour and service characteristics. The findings of the study are broadly consistent with contemporary research concerning this population, particularly in relation to the nature and frequency of offending, history of offending, psychopathology, age and gender distribution. However, very few of those referred had any form of structured care plan, despite having significant offending histories, and this may have compromised early identification of their needs and communication between the health, social and other services involved.

Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood, schizophrenia, sexual abuse and physical abuse have been associated with offences in adulthood. This study investigates these variables in relation to large cohorts of offenders with learning disabilities. A case note review was undertaken for 126 individuals referred but not accepted into forensic learning disability services and 197 individuals accepted for such services. Results are reported on diagnostic information and experience of adversity in childhood. ADHD/conduct disorder featured prominently in both groups. Autistic spectrum disorders were not particularly over‐represented. For adversity in childhood, general socioeconomic deprivation featured prominently in both groups. This also increased significantly for those accepted into services. Sexual abuse and non‐accidental injury were featured at around 13‐20% for both groups. These results are broadly consistent with the mainstream literature on offending, ADHD/conduct disorder and general deprivation featuring significantly in all groups and rising for those accepted into offender services. It is important to deal with these aspects during assessment and to provide appropriate psychotherapeutic services for these individuals.

The purpose of this paper is to ascertain what efforts Adult Safeguarding Leads (ASLs), generic advocates, and Independent Mental Capacity Advocates are making to involve service users in decisions about protective measures, and to investigate whether the Adult Safeguarding service is delivering outcomes, which are valued by its users.

Semi-structured interviews with a sample of key stakeholders.

ASLs are making efforts to involve service users in the complex and demanding process of safeguarding. These efforts, however, are shaped by their understandings of the difference between “residential” and “community” settings.

The study is based in a single County Council, albeit in a large county, and involves a limited number of service users.

Clarification is needed of what it may mean to adopt a person-centred approach to adult safeguarding, and the responsibilities of ASLs when individuals with capacity to make decisions about this aspect of their lives are unwilling to engage with the safeguarding process.

The findings improve the understanding of how ASLs understand their responsibilities towards the users of their services and endeavour to involve them in the adult safeguarding process. Based on this understanding, those with responsibility for managing Adult Safeguarding services should be better able to support improvements in professional practice.

The purpose of this paper is to analyze the impact of microcredit on per capita income of farm households in Cameroon. It discusses short- and long-term implications of access to microcredit on income poverty.

The authors interviewed rural households with agriculture being either their first or second income-creating activity. All sampled households are clients of a Cameroonian village bank. The authors used a balanced panel with a treatment and a control group, the latter not having had a village bank microcredit yet. The results were reaffirmed using bootstrapping.

This paper argues that microcredit has had a significant positive impact on per capita income in the short run, but the long-term effect was negative, albeit not significant. In the long run, absolute income poverty had further decreased in the treatment group, however, not as much as in the control group. Because the treatment group had been shifting back to the informal financial sector and had diverted part of the microcredit for consumption, this may have led to lower marginal income effects. Productivity of credit financed inputs by the treatment group remained constant, which also explains why the treatment group fell back over time.

The balanced panel data set was relatively small due to attrition over time. This was accounted for using bootstrapping. Nevertheless, research results must be interpreted with care. Furthermore, the discussion is not exhaustive.

Despite tremendous methodological advancements regarding the impact analysis of microcredit on income poverty, findings remain controversial and inconsistent. Frequently, fungibility is a confounding issue. Microcredit policy ought to consider more long-term effects.

There is much discourse amongst development economists about the impact of microcredit on poverty. Research based on panel data may clarify some of the controversial issues. This research paper uses a rather unique panel data set from Cameroonian farm households that are clients of a private sector village bank. The issue of sample size limitation is dealt with using bootstrapping. The authors base the empirical analysis on a comprehensive and theoretically founded economic farm household model.

The purpose of this paper is to explore the effects of legislative amendments to the Dangerous Drugs Act in 2015 and the establishment of a Cannabis Licensing Authority (CLA) in Jamaica as the first Caribbean country to decriminalize cannabis and attempt to establish a medical cannabis industry. The research also attempts to understand the perception of key industry players and interest groups to the existing regulatory framework in Jamaica.

The research reviews local and global trends, the developments in cannabis legislation and conducts questionnaires as well as semi-structured interviews to get feedback from key industry stakeholders and interest groups.

The findings suggest that there is a lack of confidence in the CLA in Jamaica, who are faced with the task of balancing the emerging medical cannabis industry and formalizing the existing illegal cannabis trade. There appears to be inconsistencies and lack of coordination between the associated ministries, departments and agencies. The CLA in Jamaica has established two separate cannabis models that appear to be incoherent in their approach to policy. On the one hand they are regulating cultivation, processing and supply, and on the other hand, the law remains unclear about the purchase or consumption of cannabis and its by-products.

Countries must learn from Jamaica’s experience if they wish to effectively establish a medical cannabis industry and legitimize existing illegal cannabis economic activities. These countries must ensure they tailor fit the approach of their CLAs to minimize any negative perception from industry players. Laws established to facilitate linkages from the cultivation to processing to packaging to transportation to retail must also include clear laws surrounding the purchase and consumption of cannabis. Jamaica has a far way to go and must continue to learn from other countries and states, for example, Holland, Spain and Uruguay, while at the same time learning from itself.

This paper is novel as it addresses the transition of the legislative process in Jamaica. It also serves as lesson for other countries that seek to engage in the development of their cannabis industries.

In 1960, Alfred Hitchcock’s Psycho stunned both the cinema-going public and critics alike. Its tale of a young, genial, likeable and mother-fixated hotel proprietor – Norman Bates (played by Anthony Perkins) – whose psychotic tendencies and fractured personality tapped into the zeitgeist of an America changing in a post-World War II world, was very much the antithesis of rock ‘n’ roll rebels like Elvis Presley and James Dean. Norman Bates was Anthony Perkins and Anthony Perkins was Norman Bates.

In 2013, Norman resurfaced from numerous remakes in Bates Motel. With its nod to the past, and a look to the future of how Norman’s story pans out, the series’ narratives, characters and situations showed there was life for him, his mother and the motel beyond cinema.

This chapter examines how Creed’s ideas of ‘Monstrous’ can be overlaid onto Norman, his mother Norman and Bates Motel.

We first provide an overview of some predominant theoretical methods currently used for predicting thermal conductivity of thin dielectric films: the equation of radiative transfer, the temperature‐dependent thermal conductivity theories based on the Callaway model, and the molecular dynamics simulation. This overview also highlights temporal and spatial scale issues by looking at a unified theory that bridges physical issues presented in the Fourier and Cattaneo models. This newly developed unified theory is the so‐called C‐ and F‐processes constitutive model. This model introduces the notion of a new dimensionless heat conduction model number, which is the ratio of the thermal conductivity of the fast heat carrier F‐processes to the total thermal conductivity comprised of both the fast heat carriers F‐processes and the slow heat carriers C‐processes. Illustrative numerical examples for prediction of thermal conductivity in thin films are primarily presented.

The No Child Left Behind Act (2002) and Race to the Top (2009) led to the highest rate of standardized-state testing in the history of the United States of America. As a result, the Every Student Succeeds Act (2015) aims to reevaluate standardized-state testing. Previous research has assessed its impact on schools, educators, and students; yet, youth’s voices are almost absent. Therefore, this qualitative analysis examines how youth of color perceive and experience standardized-state testing.

Seventy-three youth participated in a semistructured interview during the summer of 2015. The sample consists of 34 girls and 39 boys, 13–18 years of age, of African American, Latino/a, Jamaican American, multiracial/ethnic, and other descent. It includes 6–12th graders who attended 61 inter-district and intra-district schools during the 2014–2015 academic year in a Northeastern metropolitan area in the United States that is undergoing a racial/ethnic integration reform.

Youth experienced testing overload under conflicting adult authorities and within an academically stratified peer culture on an ever-shifting policy terrain. While the parent-adult authority remained in the periphery, the state-adult authority intrusively interrupted the teacher-student power dynamics and the disempowered teacher-adult authority held youth accountable through the “attentiveness” rhetoric. However, youth’s perspectives and lived experiences varied across grade levels, school modalities, and school-geographical locations.

In this adult-dominated society, the market approach to education reform ultimately placed the burden of teacher and school evaluation on youth. Most importantly, youth received variegated messages from their conflicting adult authorities that threatened their academic journeys.